04D2178514 CLIA NUMBER - ARCARE 136

Laboratory Demographics

  • CLIA Code: 04D2178514
  • Facility Name: ARCARE 136
  • Facility Address: 3057 SPRINGDALE AVENUE
    SPRINGDALE, AR
    ZIP 72762
  • Facility Phone: 479 756-1699
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: KRISTINE M. PRUITT
  • NPI Number: 1952934119
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2178514
LAB Type Federally Qualified Health Center
Facility Name ARCARE 136
Street 3057 SPRINGDALE AVENUE
City SPRINGDALE
State AR
ZIP 72762
Phone 479 756-1699
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2024
Certificate Expiration Date 2/3/2026
Facility Type Federally Qualified Health Center
Lab Director KRISTINE M. PRUITT

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This page was last updated on: 9/29/2025